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背景虽然儿童癌症幸存率显著增加,但幸存者要面对威胁生命远期作用增高的风险,包括继发癌。目的就幸存者预期寿命,评价与疾病和治疗相关死亡风险的累积作用。设计用状态转移模型模拟儿童癌症幸存者寿命临床过程。设施儿童癌症幸存者研究。对象患儿童癌5年幸存者。测量针对儿童癌幸存者寿命,评价诊断为原发癌死亡风险;继发癌和心脏、肺、外部和其他并发症剩余死亡风险和固有死亡(一般人群年龄-特异死亡)的概率。结果 10岁时被诊断为癌症、5年、15岁幸存者定群研究,平均寿命几率迟发死亡率为0.10;治疗-相关继发癌和死于心脏、肺和外部原因为0.15;死于其他剩余风险为0.05。15岁者预期寿命为50.6岁,与一般人群比较,要少10.4岁(17.1%)。因诊断不同预期寿命减少程度也不同,范围从肾肿瘤幸存者的4.0岁(6.0%)到脑及骨肿瘤幸存者的17.8岁更易存在迟发死亡风险,剩余死亡风险持久。有限性所评价有基础数据幸存者接受的是20～40年前的治疗方法,接受新疗法病人可有较好的结果。结论儿童癌幸存者成人期要面对较大死亡风险,剩余风险可使预期寿命减少28%。有必要做好目前幸存者的健康状况监测;对癌新发病例、治疗迟发毒力应仔细评估。
Background Although the survival rate of childhood cancer has increased significantly, survivors face the risk of long-term threats to life, including secondary cancers. Objectives To assess the cumulative effect of survivor life expectancy on disease and treatment-related mortality risks. The state transition model was designed to simulate the clinical course of childhood cancer survivors’ lifespan. Facilities Child cancer survivor research. Target children with 5-year survivors of childhood cancer. Measuring the lifetime for childhood cancer survivors, evaluating the diagnosis of the risk of death from primary cancer; the probability of residual cancer death and inherent death (age-specific death of the general population) secondary to cancer and heart, lung, external and other complications. Results 10-year-old was diagnosed with cancer, 5-year, 15-year-old survivors group study, the average life-time risk of death was 0.10; treatment-related secondary cancer and died of heart, lung and external causes of 0.15; died of The other residual risk is 0.05.15 The life expectancy at birth is 50.6 years, which is 10.4 years (17.1%) less than that of the general population. Because of the different degrees of reduction in life expectancy at diagnosis, the risk of late death ranges from 4.0 years (6.0%) in renal cancer survivors to 17.8 years in brain and bone tumor survivors, leaving the risk of remaining fatal. Findings of the data evaluated Survivors of the underlying data are those treated 20 to 40 years ago and those receiving new therapies have better outcomes. Conclusion Childhood cancer survivors face a greater risk of death during adulthood and the residual risk reduces life expectancy by 28%. It is necessary to monitor the current state of survivors’ health. For newly diagnosed cases of cancer, treatment of delayed virulence should be carefully evaluated.